BRFSS Frequently Asked Questions

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The Behavioral Risk Factor Surveillance System (BRFSS) is the nation's premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services. The BRFSS collects data in all 50 states as well as the District of Columbia and three U.S. territories. BRFSS completes more than 400,000 adult interviews each year across the nation, making it the largest continuously conducted health survey system in the world.

The BRFSS is a cross-sectional telephone survey conducted by state health departments with technical and methodological assistance provided by the Centers for Disease Control and Prevention (CDC). The states use a standardized core questionnaire, optional modules, and state-added questions to ask a variety of important health-related topics. The survey is conducted using Random Digit Dialing techniques on both landlines and cell phones. It is administered continuously throughout the year and targeted at non-institutionalized adults 18 years of age and older.

The Nebraska Department of Health and Human Services (DHHS) contracts with the University of Nebraska‐Lincoln, Bureau of Sociological Research (BOSR) to manage BRFSS data collection. BOSR conducts the interviews in a Nebraska DHHS calling center located in Lincoln, Nebraska.

BRFSS participants are asked questions about their health‐related risk behaviors and events, chronic health conditions, and use of preventive services. BRFSS also collects data on important emerging health issues such as vaccine shortage and influenza‐like illness. For example, since September 2009, federal, state, and local health agencies have used BRFSS to monitor the prevalence rates of influenza‐like illness to help with pandemic planning. General demographic information such as age, race, sex, income, education, and disability status are also collected.

The information collected during all BRFSS interviews is confidential, and the survey is conducted according to strict CDC protocol. Before answering any of the health‐related questions, participants are informed that they will not be asked for their name, address, or other personal information that can identify them, and that all information they provide will be confidential. The phone numbers called as part of the BRFSS are randomly generated with no personal information connected to them.

In Nebraska, BRFSS data are used at the state and local levels to identify emerging health problems, establish and track health objectives, and develop, implement, and evaluate a broad array of disease prevention activities. BRFSS data are one of the most important sources of health information in the state, and continue to serve as a foundation for state and local‐level planning efforts, such as the 2016 State Health Assessment for Nebraska and for Community Health Assessments that are completed by local health departments across Nebraska.

Adults 18 years or older are asked to take part in the survey. Participants are not compensated monetarily but should know that they are taking part in a rewarding endeavor that helps improve the health of Nebraska residents. Each year, at least 15,000 Nebraska adults are interviewed as part of the BRFSS.

Each state uses a standardized core questionnaire, where some core questions are asked every year (fixed core) and others are asked every other year (rotating core). BRFSS also has included space for as many as four emerging core questions for high‐priority topics such as vaccine shortage, and influenza‐like illness. All states must ask all core questions. Each state then has the option to include more questions on the questionnaire by adding optional modules (questions that CDC makes available for states to choose as part of their questionnaire) or state‐added questions (questions that are not part of the CDC questionnaire but states feel are important and choose to ask). In Nebraska, a variety of optional questions are asked each year. These questions are selected based on the interests and needs of state programs and external public health stakeholders.

Copies of BRFSS questionnaires can be obtained on the CDC BRFSS website and on the Nebraska DHHS website. On the CDC website, annual questionnaires dating back to 1984 are available under the BRFSS Questionnaires link at the following website www.cdc.gov/brfss. On the Nebraska DHHS website, Nebraska‐specific questionnaires for years 2011‐present are available under the Questionnaires link at the following website www.dhhs.ne.gov/pages/brfss.aspx.

Since 2011, interviews have been completed using both landline and cell phones. If an individual is called on their cell phone by a state they do not live in, their responses to all core questions will be coded to the correct state before the database is finalized at the end of the year.

From the 1980s to 2010, CDC used a statistical method called post stratification to weight BRFSS survey data to known proportions of age, race and ethnicity, sex, and geographic region within a population. In 2011, the BRFSS moved to a new weighting methodology known as iterative proportional fitting or raking. Raking has several advantages over post stratification. First, it allows the introduction of more demographic variables, such as education level, marital status, and home ownership, into the statistical weighting process than would have been possible with post stratification. This advantage reduces the potential for bias and increases the representativeness of estimates. Second, raking allows for the incorporation of a now‐crucial variable, telephone ownership (landline and/or cellular telephone), into the BRFSS weighting methodology.

Beginning with the 2011 dataset, raking succeeded post stratification as the BRFSS statistical weighting method. As noted, age, sex, categories of ethnicity, geographic regions within states, marital status, education level, home ownership and type of phone ownership are currently used to weight BRFSS data.

For general information about the BRFSS, copies of national BRFSS questionnaires, national and state‐specific BRFSS results, and downloadable data sets visit the Centers for Disease Control and Prevention (CDC) BRFSS website: www.cdc.gov/brfss. For Nebraska specific BRFSS information, include copies of Nebraska questionnaires and state and local BRFSS results visit the Nebraska DHHS BRFSS website at www.dhhs.ne.gov/pages/brfss.aspx.